Medical Code Expert
Medical Coding Review
When it comes to medical coding review in court, we use our knowledge to act as expert witnesses for lawyers when medical coding issues arise. While most providers and physicians put a lot of effort into complying with coding guidelines, there are cases of health fraud that leave people with billing errors and legal difficulties. Our coders work to help make medical coding problems understandable.
What is Medical Coding?
Medical coding is the process of translating medical situations into codes so that they are understandable to all individuals in the medical industry. Basically, an issue like a sore throat is reported so that all doctors understand it, and so that medical billing remains completely accurate.
The only problem is that medical coding and the process may not be easy for people without expertise to understand.
Call EvolvMD Today at 407.992.6278.
What We Do
As experts in the medical coding field, we ensure that instances of health care abuse are understandable to all parties in the courtroom. We look for anything that is inconsistent with acceptable business and or medical practices to prevent any intentional misrepresentation or deceit for the purpose of receiving greater reimbursement.
This includes problems in the coding practice, such as invalid codes, unbundled services, upcoding, inappropriate modifiers, undocumented services, or anything medically unbelievable or medically unnecessary.
Our knowledge and expertise ensures that we know what to look for here, and that we know the structure of medical coding developed by the American Medical Association—called the Physician’s Current Procedural Terminology.
Much of medical coding is done through this procedural terminology. That’s how we identify overbilling, abuse, or fraud, and how we look at different disease codes. The manual process of auditing health care claim codes and dissecting all the medical documentation is complex, however, which is why we will help perform coding reviews and check out coding compliance for your court cases.
If you’re in the middle of a healthcare fraud investigation, our medical coders know how to assess and audit medical files to check that all coding has been done properly. We are also completely prepared to successfully perform litigation and give testimony.
As experts in the medical coding field, we ensure that instances of health care abuse are understandable to all parties in the courtroom. We look for anything that is inconsistent with acceptable business and or medical practices to prevent any intentional misrepresentation or deceit for the purpose of receiving greater reimbursement.
This includes problems in the coding practice, such as invalid codes, unbundled services, upcoding, inappropriate modifiers, undocumented services, or anything medically unbelievable or medically unnecessary.
Our knowledge and expertise ensures that we know what to look for here, and that we know the structure of medical coding developed by the American Medical Association—called the Physician’s Current Procedural Terminology.
Much of medical coding is done through this procedural terminology. That’s how we identify overbilling, abuse, or fraud, and how we look at different disease codes. The manual process of auditing health care claim codes and dissecting all the medical documentation is complex, however, which is why we will help perform coding reviews and check out coding compliance for your court cases.
If you’re in the middle of a healthcare fraud investigation, our medical coders know how to assess and audit medical files to check that all coding has been done properly. We are also completely prepared to successfully perform litigation and give testimony.
Give Us a Call
We’ve spent years going through medical records and coding, and know how to use these skills to help with everything from acting as legal experts to audits and compliance. If there’s a piece of a bill that you’re unsure about, or that you as a lawyer wonder if you’ll really be able to explain to the court, we can help.
We’ll be your medical coding experts, and will go through all the difficult medical jargon so that you don’t have to. Just give us a call to learn more about how our experts might be able to help you, and how a consultation with one of our experts can help you with your trial.